Provider Demographics
NPI:1265488142
Name:HAROLD BROWN MD
Entity Type:Organization
Organization Name:HAROLD BROWN MD
Other - Org Name:PHYSICIANS HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD - PROPRIETOR (OWNER)
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-695-3897
Mailing Address - Street 1:804 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:MI
Mailing Address - Zip Code:49107-1444
Mailing Address - Country:US
Mailing Address - Phone:269-695-3897
Mailing Address - Fax:269-695-0460
Practice Address - Street 1:804 E FRONT ST
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:MI
Practice Address - Zip Code:49107-1444
Practice Address - Country:US
Practice Address - Phone:269-695-3897
Practice Address - Fax:269-695-0460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI030811207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N80940Medicare ID - Type Unspecified